Now that the Supreme Court has spoken and upheld the Affordable Care Act (ACA), how exactly does this impact state governments?

 

One of the biggest ramifications of this decision revolves around the ACA’s individual mandate requiring citizens to purchase some form of health insurance or face a penalty, and the subsequent requirement for each state to establish a health insurance exchange (HIX).

 

While many states have spent the last two years preparing themselves in some capacity to set up an exchange, the amount of progress made varies greatly from state to state. Some have taken measureable strides to ensure their exchange is up and running to meet the October 2013 enrollments and January 2014 coverage effective deadlines set forth by the ACA, while others have been waiting on the final decision from the Court. Now that it’s been made, we’re going to see these states in a scramble to build their HIXs in accordance with the ACA’s mandates and timeline.

 

What we’re hearing from our clients indicates the majority want to make health reform as state-specific as possible. In other words, they want to maintain control over their HIX rather than defaulting to the federal solution. But as the certification deadline looms, it’s increasingly important for states to consider a comprehensive solution that doesn’t require building a product and allows time for customization.

 

We have formally announced our Health Insurance Exchange solution, which enables us to provide a customizable HIX solution that states can tailor to meet the needs of their residents and small businesses and be sure it’s ready on time. We were recently awarded an ACA-compliant exchange in Nevada and also announced a partnership with Florida Health Choices to build Florida’s insurance marketplace.

 

As federal rules regarding HIX development are still evolving, states have many decisions to make around governing rules and scope, all while managing the very complex, expanding, and resource-intensive Medicaid program, another huge impact the ACA will have on states.

 

The expansion of the Medicaid program means more than 15 million new healthcare consumers selecting and enrolling in a health plan, so states must be ready to meet this new market and have a partner onboard with a strong portfolio of technology and services to help them.

 

From a policy and programmatic standpoint, the process of administering this influx of new beneficiaries is going to be complex. Obviously, state budgets will continue to be challenged by the fiscal impact of these 15 million new consumers, so states will look to technology vendors to provide efficient services and program management services to help manage the cost of care. Having spent the last two years in meetings with every state, Xerox is in a great position to help them deliver these programs.

 

This decision is a landscape-shifting event and now more than ever, partnerships are essential. It’s also a very exciting time because there’s been a bit of paralysis in the market for the last two years, but we’re energized and also humbled by the challenges ahead.

 

-XXX-